EVALUATION OF PORT-WINE STAINS BY LASER-DOPPLER PERFUSION IMAGING ANDREFLECTANCE PHOTOMETRY BEFORE AND AFTER PULSED DYE-LASER TREATMENT

Treatment of choice for congenital capillary malformations of the port wine stain type is presently the pulsed dye laser. Although treatment results have usually been excellent or good, a few patients respond l ess well. Looking for a tool to predict and monitor the treatment we u sed laser Doppler perfusion imaging and reflectance photometry. Measur ements with laser Doppler perfusion imaging were performed in 19 patie nts initially and after 1-3 treatments and with reflectance photometry initially and after 1-6 treatments. Before treatment, 15 of the patie nts had an increased bloodflow within the port wine stain in compariso n with normal contralateral skin. After the laser treatments, 15 of 18 patients had decreased bloodflow within the lesion and all 18 had sur rounding hyperemia. Reflectance photometry showed a successive increas e in blanching and predicted within 6 weeks of the first treatment the eventual clinical result. The bloodflow, as measured with laser Doppl er perfusion imaging, did not correlate well with the photometrically registered erythema. Reflectance photometry is a useful objective tool , which early in the treatment course indicates whether laser therapy will be successful. Laser Doppler perfusion imaging is less helpful in monitoring patients but may be of use in the study of port wine stain pathophysiology.